Integration of cancer screening into routine HIV care facilitates early detection, Spanish study finds

Results from an ongoing study in Spain found that integrating comprehensive cancer and pre-cancer screening into routine care for people living with HIV facilitated the early detection of abnormalities and was considered feasible by providers.

About This Study

“Early Detection of Cancer and Precancerous Lesions in Persons with HIV through a Comprehensive Cancer Screening Protocol” was published online on July 3, 2024, in Clinical Infectious Diseases. The lead author is Félix Gutiérrez, M.D., M.Sc., of the Hospital General Universitario de Elche and the Universidad Miguel Hernández, both in Alicante, and CIBERINFEC in Madrid, all in Spain.

Key Research Findings

In a cross-sectional analysis, researchers evaluated data on an enhanced protocol for cancer and pre-cancer screening versus standard of care in people living with HIV in Spain, with a goal of comparing the two strategies as part of routine HIV care. All participants underwent testing for breast, liver, prostate, cervical, and anal cancer, according to Spanish guidelines. In the enhanced study arm, some of these tests were performed at younger ages or with different criteria, and participants in that arm were also checked for skin and lung cancer.

The parent study included 1,430 people, 1,172 of whom were screened with 3,181 tests and are included in the current analysis. Most participants in this analysis were middle-aged (median age 54 years) and male at birth (79% of participants), and nearly all were virally suppressed (98%). Forty-three percent of participants had a history of smoking and 40% of participants were men who have sex with men.

Overall, 4% of tests found pre-cancerous lesions or early stage cancer, mainly during anal and colorectal cancer screenings. Among the 109 participants with lesions, 65 people (5.5%) had low-risk lesions, 35 participants (3%) had pre-cancerous lesions, and nine people (0.8%) had early-stage cancer.

Of 35 surveys completed by HIV providers, most considered the protocol acceptable (97% of respondents), appropriate (91%), and feasible (77%).

Discussion Highlights and Implications for Practice

Study limitations reported include the low overall number of malignancies and unclear implications of screening for neoplasms. Lung cancer screening has been added to the Spanish standard of care since data were collected for this analysis, the researchers said.

Study authors concluded that the 84% adherence rate to the protocol, as well as providers’ positive opinions, suggested that it could be implemented in real-world settings. Additional analyses are in process, and the parent study will run until 2028.

By Barbara Jungwirth